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Individual

MALLORY DIMLER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PH.D.

Contact information

Practice address
115 MILL ST., MCLEAN HOSPITAL, BELMONT, MA 02478
(617) 855-3618
Mailing address
115 MILL ST, MCLEAN HOSPITAL, BELMONT, MA 02478

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
9958
MA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
110026265E
MA
Enumeration date
08/31/2012
Last updated
03/08/2016
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